Download - TUMBUH KEMBANG 2013
PERAN RADIOLOGI dalam
ANALISA TUMBUH KEMBANG
dr. Lila Indrati, SpRad
Odontogenesis is the complex process by which teeth form from embryonic cells, grow, and erupt into the mouth.
ODONTOGENESIS
Dentition
• Primary dentition – develops during prenatal period– 20 teeth
• Permanent dentition – develops as the jaw grows and matures– 32 teeth
• period in between – during the preteen years– mixed dentition period
Enamel, dentin, cementum, and the periodontium must all develop during appropriate stages of fetal development.
Primary (baby) teeth start to form between the sixth and eighth weeks
Permanent teeth begin to form in the twentieth week
ODONTOGENESIS
© l.m.brocklebank
Normal dental development
• permanent - 32:– incisors - 8
– canines - 4– premolars - 8– molars - <12
• deciduous - 20: – incisors - 8
–canines - 4–premolars - 0–molars - 8
Dental agePanoramic radiograph
The Growth
dental age chronological age.
DEMIRJIAN
Bone age assessment
At birth :
Only metaphyses are present epiphysis elongation
(end of the growing bone) epiphyses calcified x-rays
Bone age : degree of maturation of bones
G r o w s skeleton change : size & shape x-ray.
Bone age assessmentRadiological examination of skeletal development of the left-hand wrist
• The Growthaccelerating or decreasing?
bone age chronological age.
• social true age
universally used
simplicity, minimal radiation exposure, the availability of multiple ossification centers for evaluation of maturity.
Method
Greulich and Pyle based on a single x-ray of the fingers, hand, and wrist
easily x-rayed with minimal radiation shows many bones in a single view.
Greulich and Pyle (GP method) : faster, easier
Tanner and Whitehouse (TW2 method) : more accurate
compared to the bones of a standard atlas
Development of the ring finger from a baby- 19 Y.In the fifth image, the epiphysis appears, which becomes wider and in the final images fuses with the metaphysis.
from the Greulich and Pyle atlas
Tanner and Whitehouse ("TW2" method) doesn’t use a scale based on the agebased on a set of bone’s standard maturity for each age population. 20 regions of interest (ROIs) located in the main bones are considered for the bone age evaluation
1. First metacarpal2. Proximal phalanx of the thumb3. Distal phalanx of the thumb4. Third metacarpal5. Proximal phalanx of the third finger6. Middle phalanx of the third finger7. Distal phalanx of the third finger8. Fifth metacarpal9. Proximal phalanx of the fifth finger10. Middle phalanx of the fifth finger11. Distal phalanx of the fifth finger
Dental development
andabnormalities
© l.m.brocklebank
• number – increase or
decrease • position• form
– individual or multiple
DENTAL AGE
Age: 15, male
Photography
Radiography
Age 19, male Stage H (by DEMIRJIAN)
Age 19, male Stage H (by DEMIRJIAN)
Age 15, maleThe epiphysis of the radius has capped it's shaft. All carpals have attained their early adult shape. Fusion is under way in the epiphyses of all distal phalanges.
Maturity indicators of individual bones and epiphyses
Age 17, femaleIn the ulna and in the heads of all fingersthe epiphyseal lines have been almost completely obliterated.In the radius thin terminal lines extend completely across the shaft (see arrow).
Age 17, femaleEpiphysial lines of ulna and radius still smooth marked. The intersticesof ulna and radius mostly ossified,but perceptible. Fusion is nearly complete.
GANGGUAN TUMBUH KEMBANG DENTOKRANIOFASIAL
ANOMALI GIGI
1. ANOMALI JUMLAH• ANODONTIA• HYPODONTIA• SUPERNUMERARI
2. ANOMALI BESAR• MICRODONTIA• MACRODONTIA
3. ANOMALI BENTUK• GEMINASI• FUSI• DENS INVAGINATUS
4. ANOMALI ERUPSI• Gigi sudah ada waktu lahir
Hypodontia is a lack of some tooth development the most common developmental abnormalities, 3.5–8.0% of the population (not including third molars).
more common in permanent than primary dentition
associated with the absence of a dental lamina
infection , chemotherapy medications
also associated with many syndromes
(Down syndrome and Crouzon syndrome )
Severe Hypodontia/Anodontia complete lack of tooth developmentjarang biasanya pd Hypohidrotic ectodermal dysplasia
Hyperdontia is the development of extraneous teeth
occurs in 1–3% of Caucasians, more frequent in Asians
86% involve a single extra tooth in the mouth, most commonly found in the maxilla (incisors)
occasionally associated with other developmental defects
more common in females than males
Double teeth· developmental anomaly· teeth usually united by dentine (with or without pulp)· more common in primary than permanent dentition· anterior teeth mainly involvedConcrescence· acquired anomaly· union by cementum alone following hypercementosis
GERMINASI PREMOLAR
Regional Odontodysplasia
Raremaxilla and anterior teeth.
cause : unknown; disturbance in the neural crest cellsInfectionradiation therapydecrease in vascular supply
Regional Odontodysplasia
never erupt into the mouthhave small crownsyellow-brownirregular shapes.
radiographs translucent "wispy," "ghost teeth"
© l.m.brocklebank
Neoplastic, odontogenic• benign
– cementomas– cementifying fibroma– myxoma
• ameloblastoma *• adenomatoid odontogenic tumour• calcifying epithelial odontogenic tumour
© l.m.brocklebank
Neoplastic, odontogenic• ameloblastoma *
• male, 15, clinical expansion• definite root resorption• thinning of cortex lingually• no cortex evident buccally• findings suggest a locally
aggressive lesion
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